Prebill Denials RN

Description

Do you want to join an organization that invests in you as a Prebill Denials RN? At Parallon, you come first. HCA Healthcare has committed up to 300 million in programs to support our incredible team members over the course of three years.

Parallon, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
• Free counseling services and resources for emotional, physical and financial wellbeing
  
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
  
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock
  
• Family support through fertility and family building benefits with Progyny and adoption assistance.
  
• Referral services for child, elder and pet care, home and auto repair, event planning and more
  
• Consumer discounts through Abenity and Consumer Discounts
  
• Retirement readiness, rollover assistance services and preferred banking partnerships
  
• Education assistance (tuition, student loan, certification support, dependent scholarships)
  
• Colleague recognition program
  
• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
  
• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

You contribute to our success. Every role has an impact on our patients' lives and you have the opportunity to make a difference. We are looking for a dedicated Prebill Denials RN like you to be a part of our team.

Seeking a Prebill Denials Nurse who will review post discharge, prebill accounts without an authorization on file, ALOS versus days authorized variances, and other identified account discrepancies that will result in denial by the payor. The Prebill Denials Nurse communicates with third party payors to resolve discrepancies prior to billing. We are an amazing team that works hard to support each other and are seeking phenomenal addition like you. We want you to apply today

What you will do in this role:

Work post discharge, prebill accounts efficiently and effectively to resolve account discrepancies.

Evaluate clinical documentation on multiple patient accounts and escalate issues through the established channels.

Perform accurate and timely documentation of all review activities.

Demonstrate a working knowledge of managed care agreements based on available resources which may include payer UM Manual, policy and procedure and facility contract information.

Work assigned accounts in eRequest to resolve outstanding issues.

Report insurance denial trends identified during daily assignments.

Contact facilities, physician offices, and insurance companies to resolve denials and appeals.

Assess CPT codes for outpatient accounts that require authorization when accounts have not been coded.

Communicate effectively and professionally with physicians, hospital staff, and outside agencies.

What qualifications you will need:

Registered Nursing degree and current licensure

Healthcare experience in an acute care hospital

Utilization Review, appeals, denials, managed care contracting experience preferred

Currently licensed as a Registered Nurse (RN) in the state(s) of practice and/or has an active compact license in accordance with law and regulation

Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.

HCA Healthcare has been recognized as one of the World's Most Ethical Companies by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated 3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

We are a family 270,000 dedicated professionals Our Talent Acquisition team is reviewing applications for our Prebill Denials RN opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.